Structure-activity state of all heart chambers during progression of chronic heart failure in patients with ischemic heart disease

Urgency. A leading role in progression of cardiovascular diseases is allocated to cardiac remodeling. Compensatory mechanisms and ways to development of cardiac dysfunction are still not completely understood. Aim: Evaluating structure-activity changes in all parts of the heart during LV postinfarction remodeling and the effect of these changes on cardiac output in progression of CHF. Materials and methods. 47 patients with postinfarction cardiosclerosis and I–IV FC (NYHA) CHF were evaluated including assessment of structure and function of the right and left heart and LV diastolic function by data from Doppler echoCG. Results. The group of patients with impaired relaxation showed right heart dilatation with normal parameters of pre- and afterload; parameters of right ventricular (RV) and right atrial (RA) remodeling correlated with parameters of left chamber remodeling. Changes in most LV structural and geometrical parameters, filling parameters and enhanced left atrial (LA) function beneficially influence cardiac output in this period. Progression of structural changes and reduction of contractile function were observed at the stage of increased LV filling pressure. Cardiac output was maintained for the most part due to dilatation of the left heart, and cardiac output correlated with the RV contractile ability.